Dog Adoption Application

PLEASE READ CAREFULLY!! Thank you for taking the time to fill out our questionnaire. The purpose of this application is to learn a little about your family and home so that our organization can make the best possible match for both you and our rescue animal. Our main concern is placing our animals in a compatible home with a family that will give them a LIFETIME commitment of love and proper care. This consultation process is designed to help us determine if the adoption is in the best interest of both the animal and the adopter. Please be aware that while completing this application does not bind you to adopt one of our animals, neither does it guarantee that we will place one of our animals in your home at this time. If you are interested in learning more about one of our animals, please answer the questions honestly and thoroughly. Some animals may need some extra time and patience to adjust to yet another new home. Some may need housetraining or other types of training, and some may just need a little extra love and patience. All animals, regardless of their background and history, go through an adjustment period when they go to a new environment. There will be a period of a few days, weeks or in some cases months during which your new petâ€™s personality is emerging and growing while you get to know one another. Please remember that this is a stressful time for an animal and hopefully we will be able to work together to make this a lifetime relationship for you and your rescue pet. You can call on us at any time to help you in any way. With this in mind, please answer the questions on the application to the best of your ability. We reserve the right to refuse adoption to anyone for any reason. A representative of our group may conduct home visits prior to or following an adoption, and our group has the right to reclaim an animal following an adoption if unsuitable home conditions, evidence of neglect, abuse or other mistreatment of the animal are found on this visit. IN ORDER TO BE CONSIDERED AS AN ADOPTER TODAY, YOU MUST: * Be 21 years of age or older. * Have identification showing your present address. * Have the knowledge and consent of your landlord. * Be willing to have a rescue representative visit your home by appointment. * Be able and willing to spend the time and money necessary to provide training, medical treatment and proper care for a pet for the entire life of that animal.

Applicant #1
*

First Name Last Name

Age

Applicant #2

First Name Last Name

Age

Relationship to Applicant #1

Address
*

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Home Phone Number

-
Area Code Phone Number

Work Phone Number

-
Area Code Phone Number

Cell Phone #

-
Area Code Phone Number

E-mail
*

Best way / time to contact you:

Applicant #1 Name & Address of employer

Occupation

Applicant #2 Name & Address of employer

Occupation

When will you be ready to adopt a dog?

Are you currently working with any other rescue groups or shelters to find a rescue pet?

Is there a specific dog that you are interested in adopting from us? If so which one? Are you interested in having us help you find a match?

If not, what type of pet are you looking for?

Do you have any children? If so what are their names and ages?

Please list the name, age & relationship of other people living in the residence.

Do you own or rent?

If you rent, what is your landlords name & phone number?

Do you have a fenced in yard? If yes please tell us the fence height.

Please list your current pets: name, age, breed, spayed/neutered?

Please list your previous pets: name age, breed, spayed/neutered?

Please list all of your pets veterinarians name & phone number. All applicants animals must be up to date on vaccinations and spayed or neutered. Please include a list of all veterinarians that have seen your pets. Please call your vets office and authorize them to release medical information to Placing Paws.

Reference #1 Please provide the name, relationship, phone number and e-mail address of someone who can provide thorough responses to questions about your suitability as a pet owner
*

Reference #2 (non-family member please) Please provide the name, relationship, phone number and e-mail address of someone who can provide thorough responses to questions about your suitability as a pet owner:
*

Is the entire family in agreement with adopting a rescue pet?
*

Do any members of the family have allergies to animals? If so, how are they treated?

Why have you decided to rescue a dog / puppy?

Will this be your first dog / puppy?
*

Have you ever surrendered a pet to a rescue / shelter? If so please explain.
*

Have you ever placed a pet into another home?
*

Have your current pets been tested for heartworm?

Are your current pets on a heartworm preventative? If so, what brand name are you using?

Is someone home during the day?

What are the work hours of all household members?

Where will your pet be kept during the day?

Where will your pet be kept at night?

Who will be the dogs primary caretaker?

Please describe your exercise plan for the dog

Please describe your house-breaking plan for the dog

Please describe your obedience training method

Are you willing to crate train your new dog?

Do you plan on taking obedience training classes?

What conditions or circumstances would cause you to give up your dog?

What would you do if your dog bit someone?

If you become unable to care for your pet please list the name and phone number of the individual that would care for them.
*

Questions or comments

By placing your initials in this box you acknowledged that you have answered all of the questions truthfully to the best of your ability and understand that we reserve the right to reject an application for any reason that we discover during the application process
*